February 21, 2011 Celeste Monforton, DrPH, MPH 17Comment

Freshman Congressman Larry D. Bucshon (R) of Evansville, Indiana is a cardiothoracic surgeon. His father was an underground coal miner and a member of the United Mine Workers Union for 37 years. Both his grandparents were coal miners. But, Republican-controlled Capitol Hill is now the Twilight Zone when I heard him say the following last week at a congressional hearing:

“I see a lot of patients with workplace related respiratory problems, some of which, to put it bluntly, are their own issue because they refuse to wear safety equipment regardless of whether there are regulations in place to do so or not.”

The congressman’s offensive remark was part of a question to Labor Secretary Hilda Solis on her department’s regulatory plan to address coal workers’ pneumoconiosis. I thought I’d heard it all, but blaming coal miners for having black lung disease?? That’s shameful.

The doctor/congressman may know cardiothoracic surgery, but he needs to pick up a few history books. When the 1969 Coal Act was being debated, physicans bought and paid for by coal operators told lawmakers that coal dust was not the cause of miners’ lung disease. Some even argued that breathing in the black dust had a protective effect. In many industries, workers have been told (lied to) “don’t worry, it’s just dust,” or “it’s not dangerous, it just makes you cough,” or “it’s safe enough to put on your morning cereal” or “you’re more likely to be hit by lightning than be harmed by this stuff.” The health of millions of workers has been harmed because they never had access to complete and accurate information about the compounds to which they were exposed, nor the appropriate controls to prevent them from being exposed.

Despite what the doctor/congressman might think, the answer is not as easy as a surgical mask and latex gloves. The most effective way to protect workers from dangerous workplace hazards is to control them at the source. With coal dust, that means controlling the dust with water sprays, ventilation and dust collectors. Wearing a respirator should be the last line of defense, and for workers who already have impaired lungs, breathing through a respirator is not even an option.

Congressman Bucshon’s remark came during a hearing of the House Education and the Workforce Committee at which Labor Secretary Hilda Solis was the sole witness. Every Labor Department program was up for grabs during the Q&A, with several witnesses harping particularly on worker safety regulations. The congressman devoted his time to complaints about the Mine Safety and Health Administration’s (MSHA) proposed regulation to prevent miners from developing black lung disease. Yes, US coal miners are still developing the progressive and disabling respiratory illness (more here, here, here, here). MSHA proposed a rule last October and the public comment period remains open until May 2. His remarks parroted those offered by the Indiana Coal Council at a public hearing about the proposed rule. (Not surprising since the congressman received substantial campaign donations from mining companies: Peabody Energy ($9,850), Barrick Gold ($5,000), and CEMEX ($5,000), among others.) The congressman said:

“My understanding is that this potential regulation may cost the industry about a Billion dollars.”

A BILLION dollars? He can’t be serious. MSHA’s preliminary economic analysis projects first year costs of the rule would be $72.4 to $93.2 million, with annual costs of less than $40 million. The U.S. coal mining industry has annual revenues of $33 Billion.

Congressman Bucshon went on:

“From my perspective as a medical physician, and understanding the coal industry, I don’t see what the really big push for regulating.”

Here’s the reason. Coal provides about 50% of our nation’s electricity, and it will continue to do so for the foreseeable future. The workers who dig it out of the ground should not, should NOT be suffering from lung diseases related to this work, especially illnesses that are PREVENTABLE. If this MSHA rule were put in place, the next generation of coal miners and their families would be spared from:

  • *2,822 cases of coal workers pneumoconiosis (category 1&2)
  • *791 cases of progressive massive fibrosis
  • *687 cases of emphysema
  • *131 deaths from non-malignant respiratory disease

Congressman Bucshon got one thing sort of right when he said

“in a coal mine, most of the exposure is not to coal dust but to silica dust.”

Yes, respirable silica dust is another serious health hazard for coal miners and other workers. Both MSHA and OSHA plan to propose rules to address that hazard later this year.

Something tells me that Cong. Bucshon won’t support those proposals either.

17 thoughts on “Congressman blames US coal miners for having black lung disease

  1. “some of which”

    This may be the case. The questions to ask are, “Does the respiratory equipment protect the lungs?” “Do some miners forgo the protective equipment?”

    If the answer is yes to the first question, then miners should be provided with protective equipment.

    If the answer is yes to the second question, then some miners’ lung problems are their own fault for not wearing the protective equipment.

    If I’m in the lab and get nitric acid in my eyes and need treatment, but I was not wearing safety glasses, then it’s my own damned fault, and I shouldn’t sue my employer for damages.

    The claims about cost of protective equipment are bogus, though.

  2. Juice:

    What if you are working in a lab and the people who run the lab refuse to install basic safety equipment, thus allowing nitric acid to spew out into a mist throughout your work environment. And then you are told by the managers that the mist is not only not dangerous, but actually good for your eyes, so you don’t need to wear goggles.

    Then you go blind.

    Would you still feel you had no right to sue your employer?

    This analogy is closer to what the mine workers face.

  3. This is typical blame the worker rhetoric. The employer is responsible for eliminating or reducing to the minimum any and all hazards to workers. Not until then can we can talk about individual behavior, the lack of supervision, proper gear, etc.

  4. Well Juice, with policy A you have a bunch of people dead from preventable disease and more suffering needlessly, and with policy B you don’t. If, as a society, we choose policy A how has anything been bettered? Would anyone be seriously harmed by policy B in a comparable way? Profit cannot compare to the real suffering of people, so I cannot see a way in which to justify advocating policy A. Seems to me like the aim of public policy should be the best outcome for the largest number of people. Your feelings about what anyone “deserves” is irrelevant. If allowing lawsuits will prevent these accidents and encourage corporate safety measures being taken seriously then they are a good thing.

  5. Did you note that Congressman Bucshon’s father was an underground coal miner?

    For the record, I’m a degreed IH. I’ve been working in H&S for 25 years. I have a dear friend who is a coal miner in WV. I agree that contaminant control is best done at the source, and that in the hierarchy of control, respirators should come last.

    Celeste, have you read the transcripts from the NPRM hearings? Go look at them:

    They aren’t all posted (I will read the others as they are completed) but I’ve read enough to have serious questions about the stated economic impact of this legislation, the science behind the regulation and the reliability of the CPDM. Until the questions that have been raised are sufficiently addressed, I would be uncomfortable supporting this piece of legislation.

  6. IrishMom,
    Yes, I noted in my post that the congressman said his father was an underground coal miner.

    The transcripts for the hearing are interesting to read. MSHA is reconcile those comments when it formulates the final rule. The evidence that the 2.0 mg standard is NOT protective of miners’ health is very strong. (See NIOSH criteria document) There are FEASIBLE means to control the dust. The law requires MSHA to demonstrate that workers face a significant risk of harm and that there are feasible means to control the dust. In this proposed regulation, they provide substantial evidence for both.

  7. Thank you, Dr. Monforton, for a great blog.

    On blaming coal miners for black lung, I wrote a term paper on black lung epidemiology for a course in the 1980s, and came across a couple incredible examples:

    * One doctor theorized that the abnormal spots on miners’ lung X-rays were due to drinking milk.

    * A psychiatrist at the University of Cincinnati med school published a paper investigating whether their difficulty breathing was due to panic attacks from their fear of roof falls.

    As to why miners resist wearing respiratory protection like the Air Stream Helmet, they told me that the respirator’s noise makes it harder to hear coal seams creaking, which gives them warning of a roof fall. They would rather risk black lung than be caught by the falling coal.

    The bottom line is just what you stated — the best prevention is effective controls enforced by government regulation.

  8. You know, it’s hard to believe this man was a cardiothoracic surgeon. I can see him stating these ludicrous remarks seeing that he is a Republican Congressman. What a serious blow to his father and family. He should be ashamed of his comments and should apologise to all the coal miners he offended!
    I do not even live in that state and am glad I do not have him as my government representative.

  9. As a former coalminer (North American Coal#7, Clarington, Ohio) I can tell you that all mines a required to have safety gear, including respirators available and most miners refuse to wear respirators. The congressman is also a surgeon. His remark came from frustration at seeing people die as a result of their own bull headedness, I’m sure.

    And to Joe, I never went to college and never had to write a term paper but not wearing a respirator because it makes too much noise is ridiculous. Most roof falls (not all) occur close to the face where there is all kinds of machinery operating, cutting and loading coal, bolting the roof, etc. Most of the time the warning you get is by the roof dripping. The seam always makes noise. The main reason most of the miners I worked with didn’t wear a respirator was that it interfered with their tobacco chewing.

    I’m sure the manufactured outrage over the congressman’s comments has much more to do with the ‘R’ after his name than what he actually said. And I’m sure they missed the part in the article about his father and grandfathers being miners.

  10. For the record, these guys are not suing their employers. They are suing the manufacturers of the respirators, and that is ridiculous. They often lie (even under oath) that they wore respirators all the time, when really they never wore them at all. Coal mining is a dangerous job. They are at risk for so many health problems its unreal. I think we need to hold the coal companies responsible when they violate safety codes and manipulate dust sampling (which happens ALL the time), and also educate our miners on the safety products available. If you don’t wear a respirator, it can’t help you. To a point, everyone has to take responsibility for their own well-being.

  11. First, I have to say that I love science. I love being an IH. Bad science (ala the A. Wakefield’s of the world) makes me crazy. Delving into these issues has been fun…in an IH sort of way. And I appreciate your blog. I’ve had it bookmarked for ages.

    At the moment, I have to disagree with your confidence in the NIOSH Criteria Document. I found Pat Brady’s statements in Evansville quite interesting – the ones in question start on pg 132. If his recollection is correct and MSHA initially rejected the NIOSH document as invalid, I would like to know the reason for the rejection. Why, if it was inadequate then, has it now been resurrected to serve as the basis for promulgating legislation? Why hasn’t NIOSH responded to all of the requests for additional information? Even the UMWA representatives have wondered at their absence in the NPRM proceedings.

    Dr. Kelsh, the epidemiologist who testified in Salt Lake City, asked good questions with regard to the studies that were done and the data that was collected. It appears that there are numerous variables that have not been controlled. Participation in the NIOSH X-ray studies is so poor that we may not know the real prevalence of CWP disease. Miners are not followed like radiation workers to obtain lifetime exposures. That kind of data would go a long way toward understanding the dose/response relationship. We do not really know if a threshold exists or if there is a NOEL/NOAEL/LOEL for coal dust and the CWP family of disease. What role does silica play? What role does bioavailable iron play? What about coal type and the seam? Transparency in this process is important. I want to see details before I rely on studies to set an OEL. If the data isn’t there to support the OEL, then additional studies need to be done. The shotgun approach has never make sense to me. Right now, there are too many nagging questions for me to feel comfortable relying on the incidence rate data listed in the NIOSH document.

    When you say FEASIBLE, are you referring to technical or economic feasibility? Quite frankly, coal mines scare the bejeebers out of me. I entered one once (many years ago) and have not been convinced to repeat the experience, so I have no frame of reference to understand the discussion with respect to technical feasibility. In an ideal world, we would not have to worry about economic feasibility, yet it is the reality that we have to live with and manage. I do it all the time when contemplating engineering controls for H&S. Several witnesses have testified that the economic feasibility estimates listed in the rule are inaccurate and have provided data. It sounds like they have valid points and those need to be addressed before the rule moves forward. I’m looking forward to reading those estimates.

    When I started studying this issue, I was startled by the current MSHA sampling protocol. It’s my understanding that they currently use averages of 5 shifts every 2 months to quantify exposure. That is a poor and highly variable way to determine an individual’s exposure. Based on my experience, I would not feel comfortable relying on that kind of data to assess exposure and protect workers for whom I’m responsible. It exists in stark contrast to the OSHA realm, where for example, sampling must cover 7hrs of an 8 hr shift in order to be statistically significant, reliable (especially for tasks where exposures are variable), and defensible. Data also needs to be repeatable to ensure that we have a realistic picture of what constitutes “normal” exposure. I’m no statistician, but it seems to me that the monitoring requirements in this regulation have swung the pendulum too far in the other direction.

    This piece of legislation will require a substantial increase in data collection. I’ve managed projects that collected thousands of data points on specific contaminants. Pre-planning is everything or when the data comes piling in, managing/interpreting that data is a nightmare. A study (and that’s what we’re really talking about here) with poor design and large amounts of data does not make for good conclusions. In my opinion, that is a huge waste of resources.

    I’ve conducted hundreds of exposure assessments through the years. Dozens have been in hot, dusty, cramped environments. In those cases, workers tend to be particularly vocal in expressing their unhappiness with wearing the monitor. I am always sympathetic. It gets in their way and I interrupt their work rhythm on a regular basis to make sure it’s still functioning. I’ve voided hundreds of samples because the pumps have failed and I can’t trust the data. After reading the testimony of the miners and Dr. Torma-Krajewski, it’s clear that the rigors of coal mining exceed what I’ve witnessed. I can’t help thinking that it’s premature to mandate the use of the CPDM in its current physical form.

    I was unimpressed with the testimony offered by Mr. Morton of Thermo Scientific (Washington, PA). There were a lot of weasel words in there. I am concerned by the issues raised with respect to the reliability of CPDMs. Exposure assessment has to be done with reliable equipment and validated sampling methodology or you might as well make up numbers. I found Mr. Cooper’s analysis of the CPDM data most interesting and look forward to reading his report in its entirety. Odd that the manufacturer, who arguably has better access to the data, has not done that kind of analysis. I hope that Mr. Cooper succeeds in his quest to collect the data from other CPDMs in use throughout the mining industry. Several people noted that the CPDM is an improvement over the 1.7 cyclone, but with the error rate described under real use conditions, I don’t believe that it’s appropriate to rely on it for compliance purposes.

    Preventing black lung is a laudable goal. No one should become sick from their work environment. At this point, I simply can’t agree that MSHA has done it’s homework or completed it’s statutory obligation with this piece of legislation.

    I wish I didn’t have to wait ~2 weeks to read the transcript from the Arlington hearing. I’ll check back after its posted and I’ve had the chance to slog through it.

  12. IrishMom,
    First, I don’t put as much credibility in Mr. Pat Brady’s testimony as you seem to. He works for the largest privately-owned coal company in the country and they have a strong economic interest in the status quo. New rules to protect miners’ lungs will cost coal companies money and thus cut into their profits. Second, I worked at MSHA when the agency attempted to promulgate a rule to address many of the same issues addressed in this regulation. At no time did MSHA’s leadership “reject” the NIOSH criteria document. At the time of that rulemaking (1999-2000), the agency leadership decided to move forward with a regulation that included many improvements (e.g., single-shift sampling instead of an averaging of sampling; dust control plan verification based on typical production; among other things) but not a change in the exposure limit. That decision was not a “rejection” of the NIOSH criteria document, but rather a decision by the leadership on what was a viable regulatory approach. (In retrospect and the benefit of hindsight, perhaps a phased-in reduction of the exposure limit should have been proposed at that time.) Ultimately these changes were proposed in July 2000, but the rulemaking was not completed by the time the GWBush Administration took office.

    As a lover of science you can surely appreciate that never have perfect science, we never have all the data we’d like. The Mine Act, like the OSH Act, expects the agencies to address health hazards that pose a signficant risk of harm “based on the best available evidence.” There is no obligation for the agency to wait for additional studies, or conduct new research.

    I was surprised to read Dr. Kelsh’s testimony because he seems to suggest that MSHA’s rule is based primarily on data obtained from the coal workers xray screening program. That data is only one piece of information used in the agency’s assessment of the hazard. The most informative document is the entire quantitative risk assessment

    In MSHA rulemaking, like OSHA, the term FEASIBLE refers to both technological and economic feasibility. MSHA considers both in its preliminary regulatory flexibility analysis.

    You’re absolutely correct that the averaging of samples for compliance purposes is ludicrous. MSHA has attempted at least 3 times to get rid of this practice, beginning in 1991, and met legal challenge after legal challenge by the coal industry.

  13. I’ve conducted hundreds of exposure assessments through the years. Dozens have been in hot, dusty, cramped environments. In those cases, workers tend to be particularly vocal in expressing their unhappiness with wearing the monitor. I am always sympathetic. It gets in their way and I interrupt their work rhythm on a regular basis to make sure it’s still functioning. I’ve voided hundreds of samples because the pumps have failed and I can’t trust the data. After reading the testimony of the miners and Dr. Torma-Krajewski, it’s clear that the rigors of coal mining exceed what I’ve witnessed. I can’t help thinking that it’s premature to mandate the use of the CPDM in its current physical form.

  14. They aren’t all posted (I will read the others as they are completed) but I’ve read enough to have serious questions about the stated economic impact of this legislation, the science behind the regulation and the reliability of the CPDM. Until the questions that have been raised are sufficiently addressed, I would be uncomfortable supporting this piece of legislation.

  15. An honest question. why didn’t the United Mine Workers Union buy/help pay for respirators for their workers? Why didn’t the miners buy them?
    Don’t argue it’s the companies responsibility. If a car crosses lanes and comes head on at me I’m going to swerve even though it was their responsibility to move.
    I have bought my own hearing when the company didn’t provide it because the noise level was just below the required OSHA level. I didn’t wait, my safety, my responsibility.

  16. Frank in PA,
    You raise some interesting questions. The majority of coal miners in the U.S. are not members of the United Mine Workers Union. I think the current percentage is only 18%. Moreover, respirators are not the appropriate first line of defense against respirable coal mine dust. The levels at which miners are being exposed are actually at or below the permissible exposure limit—-but it is out of date and not adequate to protect miners’ health.

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